Healthcare Provider Details

I. General information

NPI: 1942947130
Provider Name (Legal Business Name): KAYLAND K ALLEN LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2022
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

208 W JACKSON ST
RIDGELAND MS
39157-2310
US

IV. Provider business mailing address

1930 EDWIN AVE
PEARL MS
39208-6253
US

V. Phone/Fax

Practice location:
  • Phone: 601-213-8971
  • Fax:
Mailing address:
  • Phone: 601-213-8971
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number3293
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: